Innocent heart murmurs are quite common in children and adolescents. These murmurs are physiologic in nature and are not associated with any structural heart disease. Not only does the idea of having a child with a murmur bring unnecessary unrest to families, but the child also often goes through numerous tests that could be avoided. It is critical to obtain a detailed history and perform a thorough physical examination to diagnose these innocent murmurs. This article reviews the different types of innocent murmurs, their characteristics, how they can be differentiated on the physical examination, and most importantly, how they can be differentiated from pathologic murmurs, which require referral to a pediatric cardiologist and additional testing.